During the past decade there has been an increasing awareness of the need for a different approach to the problem of bilharziasis. We do know that 180-200 million people are infected and that the infection is increasing but we have not as yet been able to answer the question: Are they suffering from a disease. Study of vital statistics or hospital records, mass biochemical or immunological tests and community surveys have not yet provided the full answer. Gradually and perhaps begrudgingly, we have come to realize that we must study the ma- initially by means of well controlled clinical observations to obtain evidence for the altered physiology, if any, due to bilharzial infection; secondly and equally important through pathological studies on individual patients to determine the structural changes, if any, as a result of infection with this parasite; and by post mortem studies. Experimental studies of bilharzial infection in animals, valuable as they may be for the elucidation of the pathogenesis of the lesions in the laboratory animal and in man cannot serve as a substitute for the precise information on the nature of the possible lesions induced by bilharziasis in man. Basically, the significance of any clinical observation can 'be evaluated only through reliable pathological confirmation.

The Novartis Foundation Series is a popular collection of the proceedings from Novartis Foundation Symposia, in which groups of leading scientists from a range of topics across biology, chemistry and medicine assembled to present papers and discuss results. The Novartis Foundation, originally known as the Ciba Foundation, is well known to scientists and clinicians around the world.

Die Krankheiten sind keine unvedinderlichen Erscheinungen, sie sind histo rischen Wandlungen und wechselnden geographischen und demographischen Ver haltnissen unterworfen. Deshalb wechselt auch das Gesamtbild der Krankheiten, das Krankheitspanorama, von Zeit zu Zeit, von Land zu Land, von Ort zu Ort. Zu den vielen Faktoren, die bei der Gestaltung des Krankheitspanoramas wirksam sind, geh6ren die Ernahrungsverhaltnisse, die sozialen und hygienischen Verhalt nisse, die Epi-und Endemien und Epi-und Enzootien mit der nachher eintreten den Immunitat, die Fortschritte der medizinischen Forschung und Therapie und schliel3lich die mit den anderen Faktoren eng verbundenen Veranderungen der mittleren Lebenslange, also heutzutage die starke Steigerung derselben, vor aHem in groBen Teilen von Europa und Nordamerika. Diese Wandlungen des Krank heitspanoramas haben u. a. HARBITZ, HENSCHEN, CmARl, KUHNT, BODECHTEL, BERG, MUNCK, HAMPERL und LOFFLER behandelt. DOERR et al. haben den Wandel der Krankheitsbilder in einer gr6Beren Arbeit abgehandelt. Auf die pathogene tische Bedeutung der starken sozial-6konomischen Umwandlungen im heutigen Afrika hat MURRAY neuerdings die Aufmerksamkeit gerichtet. In Landern mit zuverlassigen statistischen Angaben sind Veranderungen der Morbiditat und Mortalitat schon innerhalb relativ kurzer Zeitintervalle bemerkbar. Ais Beispiel sei folgende Tabelle angefUhrt, die schwedische Verhaltnisse betrifft und die Verschiebungen der Mortalitat innerhalb einiger der wichtigsten Krank heitsgruppen zeigt. In die TabeHe sind nur die wichtigsten Gruppen aufgenom men, die gr6Bere Veranderungen zeigen.

A comprehensive, and profusely illustrated description of the common and uncommon images which will be found in a wide range of tropical diseases, correlated with the clinical and laboratory findings, and the epidemiology and pathology. Each chapter is an in-depth study with many images at all stages of the infections. Volume 1 includes amebiasis, schistosomiasis, hydatid disease, Chagas' disease, tuberculosis, the mycoses, taeniasis (tapeworms) and cystircercosis, and also AIDS as seen in the tropics. This is a unique book which will be of immense value, not only to all those in the practice of tropical medicine, but also to help recognition and understanding of the unusual illnesses which may be seen in travellers and immigrants.

Stone in the urinary tract has fascinated the medical profession from the earliest times and has played an important part in the development of surgery. The earliest major planned operations were for the removal of vesical calculus; renal and ureteric calculi provided the first stimulus for the radiological investigation of the viscera, and the biochemical investigation of the causes of calculus formation has been the training ground for surgeons interested in metabolic disorders. It is therefore no surprise that stone has been the subject of a number of monographs by eminent urologists, but the rapid development of knowledge has made it possible for each one of these authors to produce something new. There is still a technical challenge to the surgeon in the removal of renal calculi, and on this topic we are always glad to have the advice of a master craftsman; but inevitably much of the interest centres on the elucidation of the causes of stone formation and its prevention. Professor Pyrah has had a long and wide experience of the surgery of calculous disease and gives us in this volume something of the wisdom that he has gained thereby, but he has also been a pioneer in the setting up of a research department largely concerned with the investigation of this complex group of disorders, so that he is able to present in terms readily intelligible to the general medical reader the results of extensive biochemical investigation in this area.